前列腺癌的早期检测,诊断评估和局部治疗:一个范式的转变
Peter Albers1, Tobias Franiel, Thomas Kötter
1Department of Urology, Heinrich-Heine University, Medical Faculty, Düsseldorf, Germany, Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Jena, Germany; Institute of Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; Institute of Pathology of the University Hospital Bonn, Bonn, Germany; German Cancer Consortium, Department of Nuclear Medicine, University Hospital Essen; Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany.
新的前列腺癌指南建议使用PSA水平和MRI进行风险适应的早期检测. 这种方法提高了准确性,避免了不必要的测试,并允许符合条件的患者更早,更少的侵入性治疗.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在德国,前列腺癌每年影响大约7.5万名男性.
- 关于早期检测,诊断和治疗的新兴数据正在重塑前列腺癌的管理.
- 重点是局部局限性前列腺癌.
研究的目的:
- 审查和更新德国前列腺癌临床实践指南 (2025年).
- 根据最近的进展,概述前列腺癌管理的新范式.
主要方法:
- 系统的文献搜索用于2025指南更新.
- 关于前列腺癌检测和治疗的当前数据的叙事综述.
主要成果:
- 建议根据风险适应的早期检测,从45岁开始进行基线PSA测试.
- 介绍了一种PSA-MRI算法,以提高检测临床显著前列腺癌的准确性.
- 扩大了低风险前列腺癌 (ISUP等级组1和2) 的积极监测标准.
结论:
- 新的PSA-MRI算法提高了诊断准确度,减少了不必要的程序.
- 预计可以及早启动必要的治疗,副作用较少.
- 确保广大地区能够获得像MRI这样的高质量诊断工具,是医疗保健面临的重大挑战.
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